Knee pain IT band


Looking for general fit advice, my gf has just started cycling the usual story of injured runner looking to keep fit.

She’s experiencing outside knee pain/likely IT band pain when running that she is attributing to cycling.

I’ve got her set up with Shimano SPD pedals and cleats. Is there any tips for position of cleat to reduce this pain?
Move cleats in/out/ back/forward
Move seat up/down.

Want to try a few things before getting a bike fit for £100.

Ask around your local cyclists and find the best retul fitter in your area. Save the 100£ by just getting the good fit to start with.

When it comes to IT band issues rehab is a major issue and not RUNNING for what seems like forever, sadly IT issues will feel great one day and you think your wonderful then go for a short run and discover quickly that you have screwed up.

LOTS of stretching, yoga, pigeon pose is good for IT band issues, spend 60 plus seconds in the position, lying flat on her back have her bring her knee up and across her chest area and use her hand to pull it over while keeping the hips flat as possible also is a good IT band stretch…

Now that is covered IT band issues can come from several things, RUNNING if it is done on uneven surfaces is a killer on the IT bands . Those people that run on the roads dont realize that it is not level, it is slanted for draining surface water which causes the hips to strain the IT bands. Running a 13.1 race on one side of the street the returning on the other side of the street hammers the same side TWICE… I honestly never have heard of anyone having IT band issues from cycling, matter of fact all the runners that I know use cycling as a means to stay fit without stressing a current IT band issue.

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The IT band is connected to the outside of the knee. Stretching and using a foam roller helps loosen the band because the tightness from the band will pull the knee off track. Also, it’s helpful to strengthen the inner quad muscles, especially the VMO (the one that looks like a tear drop). This will keep the kneecap aligned better as well.

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I struggled with this for about 2 years. I found it easier to point my toes out more. Fixing the problem to be get running again require core strength training, compound lifts of squats, deadlifts etc. Good luck!

Some great advice here. I actually found my love for cycling because I had IT band issues while running and cycling didn’t bother it at all. I learned to always switch sides of the road while running if possible, I learned fixing IT band is all about strengthening the hip muscles. Stretching and rolling didn’t do much for me. I got in a routine I would do every day even after the IT band pain went away and it never came back after having it twice. Check this video out. It helped me.


I’d suggest getting at a proper bike fit to address discomfort.

I’ve been slowly incorporating things from BikeFit. Check it out but it’s a good idea to get fit from and experienced fitter.

This diagram provides some info on how to adjust pedal cleats but not for fit issues which have more to do with foot-shoe interfaces.

image s



I used to get IT band problems from running and it was a pretty easy cure. A photo of me running showed my knee bowing inwards across my centreline (I was completely unaware of this) and this was irritating my IT band.

The fix was to strengthen my Gluteus Medius by doing sidesteps with an elastic band around my ankles and doing clamshells. Also a foam roller is a must.

Thanks some good points here thanks. I’m inclined to think it’s a running issue.

I may have to get a proper fit as there is no harm in doing it. Only will be better for biking down the line.

  1. Never foam roller over your ITB - this was advice I was given by a PT. For one it just hurts too much and it hurts for a reason.
  2. One of the stretches I was given was a Rectus Femoris stretch, hook up one foot on a table etc and push hip forward and rotate pelvis forward. When I started doing it I was in agony at the outside of my knee. This was explained as the ITB and the outer quad muscle “sticking” together, I persevered and the pain has now gone.

I’d highly recommend stretching the Rec Fem and not foam rolling the ITB.

Is she pushing a big gear with low rpm. That was the mistake I was making when first started cycling 6 years ago. I now ride higher cadence also I worked on my Glutes with things like clamshells also use foam roller on my thighs… this loosens IT band. Good luck.

A simple move of the cleat outwards fixed my medial pain, since the pain is on the IT band side, you could try moving the cleat inwards… it was only a small move, but the pain is now gone entirely!

I got the info from a bikeradar article with this image:

I had this issue after cycling for about an hour. I would get pain behind and to the outside of my knee which my was diagnosed as IT Band syndrome when I got a bike fit. The research I did suggested that you cannot stretch the IT Band itself but you can stretch the muscles it attaches to at the top of the leg. I was able to fix it quite quickly following the method in these two videos. I did the stretches every other day for a few weeks and have continued to do them.

Good luck.

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Hey all - Any advice on when to stretch and do these exercises? Before or after a workout? I am 4 workouts into the SSB plan and am finding some IT band tightness creeping up. I haven’t ever had issues riding, only running. So I stopped running a few years ago but also stopped doing the exercises because I wasn’t hurting (and I was lazy). Now that it is impacting my riding it must be address immediately!

Any other success stories doing these stretches/exercises?

Warm up before exercise, Stretch afterwards (when the muscles are walm) don’t stretch cold

Totally agree. It will damage the IT band. Hip abductor exercises are the best. I had this problem but got rid of it by lower my saddle about 5mm and doing hip abduction exercises.

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